Friday, June 10, 2005

Canadian health care

Boy, reading the NEJM, BMJ and Lancet, I thought Canada was a medical utopia where everyone had free, efficient care at an overall cost much less than that of the United States. I guess not:

The Canadian health care system provides free doctor's services that are paid for by taxes. The system has generally been strongly supported by the public, and is broadly identified with the Canadian national character. Canada is the only industrialized county that outlaws privately financed purchases of core medical services.

But in recent years patients have been forced to wait longer for diagnostic tests and elective surgery, while the wealthy and well connected either sought care in the United States or used influence to jump medical lines.

The court ruled that the waiting lists had become so long that they violated patients' "life and personal security, inviolability and freedom" under the Quebec charter of human rights and freedoms, which covers about one-quarter of Canada's population.

"The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care," the Supreme Court ruled. "In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."

The case was brought to the Supreme Court by Jacques Chaoulli, a Montreal family doctor who argued his own case through the courts, and George Zeliotis, a chemical salesman who was forced to wait a year for a hip replacement while he was prohibited from paying privately for surgery